Schaut A, Cloché V, Mouna A, Angioi K, Berrod J-P, Conart J-B, Maalouf T
Service d'ophtalmologie, CHU Nancy-Brabois, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
Service d'ophtalmologie, CHU Nancy-Brabois, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
J Fr Ophtalmol. 2018 Nov;41(9):814-822. doi: 10.1016/j.jfo.2017.12.014. Epub 2018 Sep 11.
To evaluate the improvement in quality of life of patients operated within 6 months for strabismus in Graves' disease using a questionnaire.
A retrospective study was based on a cohort of patients undergoing strabismus surgery for Graves' disease at the Nancy university medical center between June 2015 and January 2017. A quality-of-life questionnaire composed of the functional GO QOL questionnaire plus 10 additional questions was given to patients. The questionnaires were completed by patients in consultation before surgery and then at six months postoperatively. A subgroup analysis was conducted to identify potential risk factors such as smoking, orbital decompression, duration of disease progression, number of surgeries, previous treatments or gender influences on the progression of the postoperative score.
Thirty-three patients (15 men/18 women) underwent surgery, with mean age 56 years; 16 (48 %) were smokers, 24 (70 %) were operated for the first time for strabismus. 8 patients (24 %) had a history of surgical orbital decompression. The mean preoperative GO QOLf was 30 (±23.8), which increased to 72 (±29.6) postoperatively (P=0.004). All the answers to the questions proposed were improved by surgery. The most improved items were difficulty in extreme gaze+6.82 points (P=0.001) and going down stairs +6.81 (P=0.002). Smokers had a lower preoperative GO QOLf than non-smokers (25±22.84 vs. 34±24.55); the same was true for their postoperative improvement (35±34.5 points vs. 50±18.8, P=0.002). History of orbital decompression did not appear to influence quality of life (21±25.39 vs. 65±33.98); the same was true for previous corticosteroid or immunosuppressant treatment (28±23.52 vs. 67±28.24), respectively P=0.42; P=0.73. Gender did not appear to influence the results P=0.17. First-time strabismus surgery patients showed a tendency which was not significant toward better improvement after 2 or 3 surgeries (respectively 45 vs. 39 vs. 33) P=0.056. There was no correlation between the duration of the disease and the change in the GO QOLf (R=0.04).
This study confirms that strabismus surgery significantly improves the quality of life of patients with Graves' ophthalmopathy. The GO QOLf demonstrates its effectiveness in highlighting this progression. Our ten additional questions proved to be very good tools for assessing this condition.
使用问卷评估在6个月内接受手术治疗的格雷夫斯病斜视患者的生活质量改善情况。
一项回顾性研究基于2015年6月至2017年1月间在南锡大学医学中心接受格雷夫斯病斜视手术的一组患者。向患者发放一份由功能性GO QOL问卷加10个附加问题组成的生活质量问卷。问卷由患者在术前咨询时填写，然后在术后6个月填写。进行亚组分析以确定潜在风险因素，如吸烟、眼眶减压、疾病进展持续时间、手术次数、既往治疗或性别对术后评分进展的影响。
33例患者（15例男性/18例女性）接受了手术，平均年龄56岁；16例（48%）为吸烟者，24例（70%）首次接受斜视手术。8例患者（24%）有眼眶减压手术史。术前GO QOLf的平均值为30（±23.8），术后增至72（±29.6）（P=0.004）。所提问题的所有答案经手术均得到改善。改善最明显的项目是极端注视困难增加6.82分（P=0.001）和下楼梯增加6.81分（P=0.002）。吸烟者术前的GO QOLf低于非吸烟者（25±22.84对34±24.55）；术后改善情况也是如此（35±34.5分对50±18.8分，P=0.002）。眼眶减压史似乎不影响生活质量（21±25.39对65±33.98）；既往使用皮质类固醇或免疫抑制剂治疗的情况也是如此（28±23.52对67±28.24），P值分别为0.42；P=0.73。性别似乎不影响结果，P=0.17。首次接受斜视手术的患者在接受2次或3次手术后有改善更好的趋势，但不显著（分别为45对39对33），P=0.056。疾病持续时间与GO QOLf的变化之间无相关性（R=0.04）。
本研究证实斜视手术可显著改善格雷夫斯眼病患者的生活质量。GO QOLf证明了其在突出这一进展方面的有效性。我们的10个附加问题被证明是评估这种情况的非常好的工具。
